(a) enter the appeal in the books of the Court and fix a day for the hearing of the appeal by a Judge in Chambers;
(b) serve on the appellant and respondent a notice in Form (6) by delivering at or posting the same to them at the address contained in the request.
Request for entry of appeal.
Form 5.
Notice of hearing.
Form 6.
SCHEDULE
FORM 1
Application for Reference to Medical Referee
IN THE MATTER OF THE WORKMEN’S COMPENSATION ACT In the matter of a claim for compensation made by A.B. ... of ... against C.D. & Co., Limited ..., of ...(or where an arbitration is pending):
In the matter of an arbitration between A.B.
of (address) ...(description) ...
...Applicant.
and
C.D. & Co., Limited... of ...(address) ...(description) ...Respondents.
(or where application is made after weekly payment has been settled):
In the matter of an agreement (or a decision or award or certificate) recorded in the above-mentioned Court as to the weekly payment payable to A.B. ..., of ..., by C.D. & Co., Limited ..., of ...
Application is hereby made to the Court on behalf of the above-named A.B.
... and C.D. & Co., Limited, for a reference in the above-mentioned matter to a medical referee pursuant to sectin 3(1) of the above-mentioned Act under the following circumstances:
1. On ...the ...day of ...notice was given by (or on behalf of) the above-mentioned A.B. ... to the above-mentioned C.D. & Co., Limited ..., of personal injury caused to the said A.B. ... by accident arising out of and in the course of his employment, in respect of which injury the said A.B. ... claims compensation from the said C.D. & Co. Limited, ...under the Act. (or where an arbitration is pending):
1. An arbitration under the Act is pending between the above-mentioned A.B. ... and the above-mentioned C.D. & Co. Limited, as to the amount of compensation payable to the said A.B. under the Act in respect of personal injury caused to him by accident arising out of and in the course of his employment (or where weekly payment has been settled):
1. Under an agrement (or a decision or award or certificate) in the above-mentioned ... matter recorded in this Court on the ... day of ...
a weekly payment is payable to the said A.B. ... by the above-mentioned C.D. & Co., Limited, ... as compensation in respect of personal injury caused to the said A.B. ... by accident arising out of and in the course of his employment.
(Rule 3).
2. The weekly payment claimed by (or payable to) the said A.B. ...
is $ ...
3. A question has (or questions have) arisen between the said A.B.
... and the said C.D. & Co., Limited, as to the condition (or fitness for employment) of the said A.B. ... [or as to whether (or to what extent) the incapacity of the said A.B. ...is due to the accident)], [or as to the condition (or fitness for employment) of the said A.B. ... and as to whether (or to what extent) the incapacity of the said A.B ... is due to the accident], and no agreement can be come to between the said C.D. & Co., Limited ...and the said A.B. ... with reference to such question (or questions).
4. The said A.B... has submitted himself for examination by a medical practitioner provided by the said C.D. & Co., Limited ...(or has been examined by a medical practioner selected by himself) (or if so, the said A.B.
... has submitted himself for examination by a medical practitioner provided by the said C.D. & Co., Limited, ... and has also been examined by a medical practitioner selected by himself), and a copy of the report of the said practitioner is (or copies of the reports of the said practitioners are) annexed to this application.
5. The applicants request that an order may be made referring the matter to a medical referee for his certificate as to the condition of the said A.B...
and his fitness for employment, specifying if necessary the kind of employment for which he is fit, [or for his certificate whether (or to what extent) the incapacity of the said A.B... is due to the accident] [or for his certificate as to the condition of the said A.B... and his fitness for employment, specifying if necessary the kind of employment for which he is fit, and as to whether (or to what extent) the incapacity of the said A.B ... is due to the accident].
Dated this ... day of ...20...
(Signed) ...
Applicant.
(or Applicant’s Attorney-at-Law) C.D. & Co.. Limited
...or ... by ... Secretary.
(Attorneys-at-Law for C.D. & Co., Limited).
To the Registrar.
NOTE—Where only one party is the applicant this form shall be used with the necessary modifications.
NOTE—Where only one party is the applicant this form shall be used with the necessary modifications.
(Rule 4). FORM 2
Order of Reference, section 13
(Heading as in application)
On the application of A.B. ... of ... and C.D. & Co., Limited, ... of ... (a copy of which is hereto annexed), I hereby appoint Mr. ... of ..., one of the medical referees appointed by the Minister for the purpose of the Workmen’s Compensation Act to examine the said ... (name of workman), and to give his certificate as to the condition of the said ...and his fitness for employment, specifying if necessary the kind of employment for which he is fit [or his certificate whether (or to what extent) the incapacity of the said ...
is due to the accident] [or his certificate as to the condition of the said ... and his fitness for employment, specifying if necessary the kind of employment for which he is fit, and as to whether (or to what extent) the incapacity of the said... is due to the accident].
Copies of the reports of the medical practitioners by whom the said ... has been examined are hereto annexed.
The said ..., who is now at ... has been directed to submit himself for examination by the referee.
I am satisfied that the said ... is in a fit condition to travel for the purpose of being examined, and he has been directed to attend on the referee for examination at such time and place as may be fixed by the referee.
(or the said ... does not appear to be in a fit condition to travel for the purpose of being examined).
The referee is requested to forward his certificate to the Registrar at the Supreme Court, Registry, Hall of Justice, Port-of-Spain, on or before the ... day of ...20...
Dated this ...day of ...20...
...
Registrar.
FORM 3
Order on Injured Workman to submit himself for Examination by Medical Referee
(Heading as in application)
To A.B ..., of ...(address and description).
Take Notice that I have appointed Mr. ..., of ..., one of the Medical Referees appointed by the Minister for the purpose of the Workmen’s Compensation Act to examine you in accordance with the application in the above-mentioned matter for a reference to a medical referee.
You are hereby required to submit yourself for examination by the referee and to attend for that purpose at such time and place as may be fixed by him.
Dated this ...day of ...20...
...
Registrar.
FORM 4
Notice to Parties of Certificate of Medical Referee (Heading as in application)
Take Notice, that I have received the certificate of the Medical Referee appointed in this matter, and that you may inspect the same during office hours at my office situated at the Registry, Supreme Court, in Port-of-Spain, and may on request and at your own costs be furnished with or take a copy thereof.
Dated this ...day of ... 20...
...
Registrar.
(Rule 5).
(Rule 6).
FORM 5
Request for Entry of Appeal (Heading as in application) To the Registrar,
Workmen’s Compensation Act.
I desire to appeal against the order of the Registrar, made on the ...
day of ... referring the matter to a medical referee under section 13(1).
The grounds of my appeal are: [set out grounds here].
I request you to enter my appeal for hearing.
The name and address of the respondent are:
My address for service is:
Dated this ...day of ...20...
...
Appellant.
FORM 6
Notice to Appellant and Respondent of Day on which Matter will be Heard
(Heading as in application)
Take Notice that the appeal in this matter from the order of the Registrar dated the ... day of ..., 20..., referring the matter to a medical referee, will be heard by a Commissioner on the ... day of ..., 20..., at the hour of... in the forenoon at the Court House, Port-of-Spain, (San Fernando) and that if you do not attend at the time and place above-mentioned such order will be made as the Commissioner thinks just.
Dated this ...day of ..., 20 ...
...
Registrar.
Workmen’s Compensation Act
(Rule 7).
(Rule 8).
WORKMEN’S COMPENSATION (APPEALS) RULES OF COURT
ARRANGEMENT OF RULES
RULE
1. Citation.
2. Interpretation.
APPLICATIONS FOR LEAVE TO APPEAL 3. Application for leave.
4. Service of notice of motion.
APPEALS 5. Contents of notice.
6. Entry of notice. Parties to be served.
7. Application for notes of evidence etc.
8. Copy of notes.
9. Appeal not to stay proceedings.
10. Extension of time etc.
11. Drawing up and filing of decision.
WORKMEN’S COMPENSATION (APPEALS) RULES OF COURT
*deemed to be made under section 49
1. These Rules may be cited as the Workmen’s Compensation